Comparison of Local Subcutaneous Infiltration with Ropivacaine Alone and Two Different Doses of Dexmedetomidine Plus Ropivacaine for Postoperative Pain after Cesarean Section Under Spinal Anesthesia

Abstract

Background: In a cesarean section (CS), good postoperative pain management is of great importance. We assessed the effect of adding dexmedetomidine to ropivacaine 0.5 in CS patients with spinal anesthesia to assess its ability to enhance pain management. Materials and Methods: This was a randomized controlled trial in Shahid Beheshti Hospital between 2022 and 2023 with the goal of assessing ropivacaine efficacy with and without dexmedetomidine on pain control after a CS. Spinal anesthesia was administered for all patients by using bupivacaine 0.5. Before wound closure, patients were treated with analgesics. Group A received dexmedetomidine 1 mu g/kg infiltrated subcutaneously, followed by ropivacaine 0.5 3 mg/kg diluted with normal saline to 40 cc. Group B received dexmedetomidine 2 mu g/kg, followed by ropivacaine 0.5 3 mg/kg. The control group received ropivacaine 0.5 3 mg/kg. A P value of < 0.05was regarded as significant. Results: The study groups exhibited significantly lower visual analog scale (VAS) pain scores. Specifically, group A showed significantly lower VAS scores than the controls, and group B also showed significantly lower VAS scores than group A. The VAS score after 24 hours of CS was, on average, 2.13 (SD = 0.16, 95 CI = 1.74, 2.52) lower in group B compared to the control group and 1.1 (SD = 0.16, 95% CI = 0.71, 1.49) lower than in group A (P < 0.05). Conclusions: Subcutaneous infiltration of dexmedetomidine with ropivacaine improves postoperative pain management more effectively than using ropivacaine alone. It is noteworthy that dexmedetomidine 2 mu g/kg can improve pain after a CS more effectively than 1 mu g/kg.